Provider Demographics
NPI:1881805349
Name:NOBLE AMA IPA
Entity type:Organization
Organization Name:NOBLE AMA IPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-941-7309
Mailing Address - Street 1:PO BOX 4909
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92052-4909
Mailing Address - Country:US
Mailing Address - Phone:760-941-7309
Mailing Address - Fax:
Practice Address - Street 1:161 THUNDER DR
Practice Address - Street 2:SUITE 212
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6016
Practice Address - Country:US
Practice Address - Phone:760-941-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management